Background: The successful review of a patient's medication regime depends on the practitioner's ability to identify and resolve actual and potential drug related problems. It is essential that practitioners undertaking this activity possess appropriate consultation skills, which allow a full assessment of the patient's medication-taking behaviour. The ability to consult has been shown to be a learnt skill1 that can be taught and developed. Therefore, a standardised framework for evaluating the consultation skills of practitioners undertaking medication-related consultations would allow the performance of individuals to be described and areas for improvement identified. Currently no such framework exists for evaluating pharmacy practitioners' approach to consulting. Hence, the aims of this research were (i) to develop a standardised framework outlining key competencies that should be undertaken in a medication-related consultation and (ii) to assess the framework's content validity.

Method: Forty-six key competencies involved in a patient-centred consultation were identified from the appropriate literature and reviewed for appropriateness by a framework development panel. Following this review an initial "Medication-Related Consultation Framework" was designed. Further face and content validity was sought by exposing these competencies to two expert discussion panels (n=5, for each) and eleven one-to-one semi-structured interviews with experts (academics, senior clinical pharmacy and medical practitioners, psychologists and other healthcare professionals). These experts systematically reviewed the framework for (i) the overall structure and content of the framework, (ii) the clarity and comprehensive nature of the individual competencies. The discussion groups and interviews were tape recorded and transcribed in full. This data was categorised using the interview questions, consultation theory and the initial framework as a guide. The framework was subsequently modified and verified by the framework development panel.

Results & Discussion: The final framework was divided into 5 main sections and 46 competencies as highlighted in Table 1.

Additionally, the competencies included in the framework, the underlying philosophies, the framework's theoretical basis and their interrelationships have been explored and will be discussed. Issues regarding the use of the framework as a formative or summative assessment tool have also been raised and will be presented. Future research will involve testing other aspects of the framework's validity, reliability and practicality. It is hoped that the framework will be used to inform consultation skills training programmes for health care professionals involved in medication related consultations.

References:
1Kurtz, S.; Laidlaw, T.; Makoul, G. & Schnabl, G. (1999) Medical education initiatives in communication skills. Cancer Prevention & Control, 3, 1, 37-45.